Healthcare Design - January 2014 - 20

INTERIORS | 02.14

Safety check
Behavioral health environments require an added level of durability and safety
when specifying products
By Lilliana Alvarado

for this specialized population, it's important to
collaborate with staff members who specialize in
behavioral health, since they know their patients best

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and will see things from a different point of view.
"I expect to be immersed in the decision-making
process when products are added to the patient care
milieu," says Vareen O'Keefe-Domaleski, vice president of patient care services and chief nursing officer
at Bradley Hospital (East Providence, R.I.). "I can feel
sharp points, find 'hidden' holes, and see ligature
points that others may not notice."
Once a better understanding of the safety needs
and features is established, it's time to look at specific
products for behavioral health facilities. Here are
some options and the design considerations to be
made for each.
Furniture and fabrics
Finding furniture that's less institutional-looking without compromising safety can be challenging. Working
with facility managers and clinical staff early in the
selection process to test furniture is critical, in order
to compare actual performance to the manufacturer's
product literature.
Furniture assembly is paramount in the decisionmaking process. Furniture must be durable and easy
to clean, and be free of parts that patients can easily
remove. Sharp edges or ligature points must be
avoided, and all furniture should be free of nails. Only
tamper-resistant screws can be used, and all bottoms of upholstered furniture must be sealed.
Since behavioral health patients tend to be
more abusive to furniture than other patients, look

Placing built-in seating with
high-performance fabrics
along the perimeter of this day
room at Brattleboro Retreat
(Brattleboro, Vt.) helps foster a
connection with nature while
maintaining durability. Wall
divisions break down the space
into private areas, with pattern
inserts in the flooring and furniture placement contributing to
this effect.

Lilliana Alvarado

COURTESY OF JOSEPH ST. PIERRE AT JSPHOTOGRAPHY (BRATTLEBORO RETREAT)

There are countless factors to be considered in product selection to create warm, inviting, and comfortable healthcare spaces for patients and staff. Those
concerns can range from ease of use to infection
control to maintainability. But when designing for behavioral health settings, further consideration needs
to be paid to durability and safety measures that
aren't required in most other healthcare settings.
Patients at behavioral health facilities can have a
variety of issues and be prone to violence and suicide. They're at risk of harming themselves or others,
including other patients and staff members.
Therefore, it's essential to make determinations
about every aspect of building design and maintenance based on the potential risk. For example, coat
hooks, grab bars, toilets, showerheads, or wardrobes need to be anti-ligature to prevent patients
from trying to hang themselves. Furniture needs to
be secured in place so it can't be thrown or moved
to block doorways, and must be free of sharp points,
screws, and hidden pieces of wood that can be
turned into weapons. Even maintenance items such
as plastic trash liners can become a suffocation
hazard for suicide-risk patients.
In addition to safety, durability features are another
concern. Beyond regular wear and tear, behavioral
health patients might actively try to destroy furniture
or finishes by slamming doors, kicking walls, throwing furniture, and puncturing fabrics.
To further understand the design considerations

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Healthcare Design - January 2014

Table of Contents for the Digital Edition of Healthcare Design - January 2014